Changes in quality of life during biofeedback for people with puborectalis dyssynergia: generic and disease-specific measures
Fen-Fen Zhu
Fen-Fen Zhu MN RN Assistant Su Zhou Health College Jiangsu Province China
Search for more papers by this authorZheng Lin
Zheng Lin MN RN Professor and Associate Director Nursing School of Nanjing Medical University and Nursing Department of the First Affiliated Hospital of Nanjing Medical University Jiangsu Province China
Search for more papers by this authorLin Lin
Lin Lin PhD Professor Department of Gastroenterology The First Affiliated Hospital of Nanjing Medical University Jiangsu Province China
Search for more papers by this authorMei-Feng Wang
Mei-Feng Wang BN RN Psychological Counselor Gastrointestinal Motility Center The First Affiliated Hospital of Nanjing Medical University Jiangsu Province China
Search for more papers by this authorFen-Fen Zhu
Fen-Fen Zhu MN RN Assistant Su Zhou Health College Jiangsu Province China
Search for more papers by this authorZheng Lin
Zheng Lin MN RN Professor and Associate Director Nursing School of Nanjing Medical University and Nursing Department of the First Affiliated Hospital of Nanjing Medical University Jiangsu Province China
Search for more papers by this authorLin Lin
Lin Lin PhD Professor Department of Gastroenterology The First Affiliated Hospital of Nanjing Medical University Jiangsu Province China
Search for more papers by this authorMei-Feng Wang
Mei-Feng Wang BN RN Psychological Counselor Gastrointestinal Motility Center The First Affiliated Hospital of Nanjing Medical University Jiangsu Province China
Search for more papers by this authorAbstract
zhu f.-f, lin z., lin l. & wang m.-f. (2011) Changes in quality of life during biofeedback for people with puborectalis dyssynergia: generic and disease-specific measures. Journal of Advanced Nursing67(6), 1285–1293.
Aim. The aim of the study was to evaluate the changes in symptoms and quality of life in people with puborectalis dyssynergia after biofeedback by using Short Form-36 and Patient Assessment of Constipation Quality of Life Questionnaire.
Background. Biofeedback is an effective treatment in clinical symptoms for puborectalis dyssynergia. However, little is known about the degree of the variation in the quality of life for these people after biofeedback.
Method. Thirty-six people with puborectalis dyssynergia were studied between June 2006 and March 2008. A bowel symptom record, a generic quality of life measure – the Short Form-36 and a disease-specific measure – the Patient Assessment of Constipation Quality of Life Questionnaire were recorded before and after biofeedback.
Findings. Thirty-one people rated their satisfaction with behavioural treatment as ‘major’ or ‘fair’ and substantial symptom improvements occurred. Before treatment, seven of Short Form-36 subscales (except bodily pain) were significantly lower in people with puborectalis dyssynergia than those in healthy individuals. Following treatment, all subcategories except general health showed improvement surpassing pretreatment baseline values and equalling those for normal. The total Patient Assessment of Constipation Quality of Life Questionnaire score also dramatically improved as did all subscales. The nurses continually encouraged the participants, increased participants’ motivation and got good outcomes.
Conclusion. Patient-centred functional status outcomes measured by general and disease-specific instruments give critical data, from which to inform patient management. The nurses should give psycho-social support and increase the participants’ motivation during training.
References
- Brandt L.J. , Prather C.M. , Quigley E.M. , Schiller L.R. , Schoenfeld P. & Talley N.J. ( 2005 ) Systematic review on the management of chronic constipation in North America . American Journal Gastroenterology 100 ( Suppl. 1 ), S5 – S21 .
- Chiarioni G. , Salandini L. & Whitehead W.E. ( 2005 ) Biofeedback benefits only patients with outlet dysfunction, not patients with isolated slow transit constipation . Gastroenterology 129 ( 1 ), 86 – 97 .
- Chiarioni G. , Whitehead W.E. , Pezza V. , Morelli A. & Bassotti G. ( 2006 ) Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia . Gastroenterology 130 ( 3 ), 657 – 664 .
- Chiotakakou-Faliakou E. , Kamm M.A. , Roy A.J. , Storrie J.B. & Turner I.C. ( 1998 ) Biofeedback provides long term benefit for patients with intractable, slow transit constipation . Gut 42 ( 4 ), 517 – 521 .
- Dennison C. , Prasad M. , Lloyd A. , Bhattacharyya S.K. , Dhawan R. & Coyne K. ( 2005 ) The health-related quality of life and economic burden of constipation . Pharmacoeconomics 23 ( 5 ), 461 – 476 .
- Drossman D.A. , Leserman J. , Nachman G. , Li Z.M. , Gluck H. , Toomey T.C. & Mitchell C.M. ( 1990 ) Sexual and physical abuse in women with functional or organic gastrointestinal disorders . Annals of Internal Medicine 113 ( 11 ), 828 – 833 .
- Drossman D.A. , Talley N.J. , Leserman J. , Olden K.W. & Barreiro M.A. ( 1995 ) Sexual and physical abuse and gastrointestinal illness: review and recommendations . Annals of Internal Medicine 123 ( 10 ), 782 – 794 .
- Emmanuel A.V. , Mason H.J. & Kamm M.A. ( 2001 ) Relationship between psychological state and level of activity of extrinsic gut innervation in patients with a functional gut disorder . Gut 49 ( 2 ), 209 – 213 .
- Faul F. , Erdfelder E. , Lang A.G. & Buchner A. ( 2007 ) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences . Behavioral Research Methods 39 , 175 – 191 .
- Heymen S. , Scarlett Y. , Jones K. , Ringel Y. , Drossman D. & Whitehead W.E. ( 2007 ) Randomized, controlled trial shows biofeedback to be superior to alternative treatments for patients with pelvic floor dyssynergia-type constipation . Diseases of the Colon and Rectum 50 ( 4 ), 428 – 441 .
- Ho Y.H. , Tan M. & Goh H.S. ( 1996 ) Clinical and physiologic effects of biofeedback in outlet obstruction constipation . Diseases of the Colon and Rectum 39 ( 5 ), 520 – 524 .
- Jones M.P. , Dilley J.B. , Drossman D. & Crowell M.D. ( 2006 ) Brain–gut connections in functional GI disorders: anatomic and physiologic relationships . Neurogastroenterology and Motility 18 ( 2 ), 91 – 103 .
- Jun D.W. , Park H.Y. , Lee O.Y. , Lee H.L. , Yoon B.C. , Choi H.S. , Hahm J.S. , Lee M.H. , Lee D.H. & Kee C.S. ( 2006 ) A population-based study on bowel habits in a Korean community: prevalence of functional constipation and self-reported constipation . Digestive Diseases and Sciences 51 ( 8 ), 1471 – 1477 .
- Lahr C.J. ( 1988 ) Evaluation and treatment of incontinence . Practical Gastroenterology 12 ( 4 ), 27 – 35 .
- Lewicky-Gaupp C. , Morgan D.M. , Chey W.D. , Muellerleile P. & Fenner D.E. ( 2008 ) Successful physical therapy for constipation related to puborectalis dyssynergia improves symptom severity and quality of life . Diseases of the Colon and Rectum 51 ( 11 ), 1686 – 1691 .
- Li N.X. , Liu C.J. , Li J. & Ren X.H. ( 2001 ) The norms of SF-36 scale scores in urban and rural residents of Sichuan province . Journal of West China University of Medical Sciences 32 ( 1 ), 43 – 47 .
- Longstreth G.F. , Thompson W.G. , Chey W.D. , Houghton L.A. , Mearin F. & Spiller R.C. ( 2006 ) Functional bowel disorders . Gastroenterology 130 ( 5 ), 1480 – 1491 .
- Marquis P. , De La Loge C. , Dubois D. , Mcdermott A. & Chassany O. ( 2005 ) Development and validation of the patient assessment of constipation quality of life questionnaire . Scandinavian Journal of Gastroenterology 40 ( 5 ), 540 – 551 .
-
Mason H.J.
,
Serrano-Ikkos E.
&
Kamm M.A.
(
2002
)
Psychological state and quality of life in patients having behavioral treatment (biofeedback) for intractable constipation
.
American Journal of Gastroenterology
97
(
12
),
3155
–
3159
.
10.1111/j.1572-0241.2002.07113.x Google Scholar
- Netscher D.T. , Meade R.A. , Goodman C.M. , Alford E.L. & Stewart M.G. ( 2000 ) Quality of life and disease-specific functional status following microvascular reconstruction for advanced (T3 and T4) oropharyngeal cancers . Plastic and Reconstructive Surgery 105 ( 5 ), 1628 – 1634 .
- O’Donnell L.J. , Virjee J. & Heaton K.W. ( 1990 ) Detection of pseudodiarrhoea by simple clinical assessment of intestinal transit rate . British Medical Journal 300 ( 6722 ), 439 – 440 .
- Pare P. , Ferrazzi S. , Thompson W.G. , Irvine E.J. & Rance L. ( 2001 ) An epidemiological survey of constipation in Canada: definitions, rates, demographics, and predictors of health care . American Journal of Gastroenterology 96 ( 11 ), 3130 – 3137 .
- Passmore A.P. , Wilson-Davies K. , Stoker C. & Scott M.E. ( 1993 ) Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination . British Medical Journal 307 ( 6907 ), 769 – 771 .
- Ramkumar D. & Rao S.S. ( 2005 ) Efficacy and safety of traditional medical therapies for chronic constipation: systematic review . American Journal of Gastroenterology 100 ( 4 ), 936 – 971 .
- Rantanen A. , Tarkka M.T. , Kaunonen M. , Tarkka M. , Sintonen H. , Koivisto A.M. & Astedt-Kurki P. ( 2009 ) Health-related quality of life after coronary artery bypass grafting . Journal of Advanced Nursing 65 ( 9 ), 1926 – 1936 .
- Rao S.S. , Seaton K. , Miller M. , Brown K. , Nygaard I. , Stumbo P. , Zimmerman B. & Schulze K. ( 2007 ) Randomized controlled trial of biofeedback, sham feedback, and standard therapy for dyssynergic defecation . Clinical Gastroenterology and Hepatology 5 ( 3 ), 331 – 338 .
- Schiller L.R. , Dennis E. & Toth G. ( 2004 ) An internet-based survey of the prevalence and symptom spectrum of chronic constipation . American Journal of Gastroenterology 99 , S234 .
- Stahl E. , Lindberg A. , Jansson S.A. , Ronmark E. , Svensson K. , Andersson F. , Lofdahl C.G. & Lundback B. ( 2005 ) Health-related quality of life is related to COPD disease severity . Health and Quality of Life Outcomes 3 , 56 .
- Wald A. , Scarpignato C. , Kamm M.A. , Mueller-Lissner S. , Helfrich I. , Schuijt C. , Bubeck J. , Limoni C. & Petrinin O. ( 2007 ) The burden of constipation on quality of life: results of a multinational survey . Alimentary Pharmacology and Therapeutics 26 ( 2 ), 227 – 236 .
- Wang Z.F. , Ke M.Y. , Sun X.H. , Guo X.F. & Fang X.C. ( 2004 ) Effect of anorectal motility and perception on patients with functional constipation . Chinese Journal of Digestion 24 ( 9 ), 526 – 529 .
- Ware J.E.. Jr & Sherbourne C.D. ( 1992 ) The MOS 36-item short form Health Survey (SF-36): I. Conceptual framework and item selection . Medical Care 30 ( 6 ), 473 – 483 .
- Wong M.S. & Chair S.Y. ( 2007 ) Changes in health-related quality of life following percutaneous coronary intervention: a longitudinal study . International Journal of Nursing Studies 44 ( 8 ), 1334 – 1342 .